Quote:
Originally Posted by Kgcetm
(Post 1799152)
I would decline to pay the bill on the basis that you did not authorize the test and that it is not routine by any measure.... Did the doctor specifically request the test?
No, I wouldn’t pay that portion of the bill and I would clearly explain that to the physician involved.
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Sorry, but you seem to not understand how it happened. Telling the doctor you won't pay this bill means nothing. The bill is not from the doctor it is from the lab. It's like telling your electric company you won't pay your phone bill. They are not involved.
Yes the doctor ordered the test. The OP clearly indicated it was ordered. No lab can do a test on its own. They only do what the doctor ordered.
As to authorization, when you gave the showed up at the lab for the tests the doctor ordered, whether with a paper order or for an electronic order, that is consent for them to draw blood. It is also routine at most encounters that you sign a form saying you will pay for any costs not paid by your insurance. That thus includes any copay, coinsurance, deductible, or non-covered tests.
The doctor ordered the test. The lab ran the test as ordered. The insurance companies declined to pay, correctly. The patient got billed.
Whether the lab did or did not specifically advise that the HIV test might not be covered is absolutely not an issue. The people working in the lab are not experts in codes and have no way of knowing whether the person having the test is having it routinely or because of a concern.
If this were my practice I would resolve it by apologizing to the couple for the misunderstanding and offer to pay the lab cost. Then I would change my office routine to be sure that if I were going to order HIV testing on people over 64 that I documented a reason they needed it or that I explained it was routine, not covered by insurance, and they patient was given an option to decline.
Then I would call the lab, explain what happened and ask that the bill be redirected to me and that I'd appreciate it if they would bill it at their insurance covered rate.
I am mystified at the cost billed. Quest does HIV screening for $89 thru their Quest Direct program
Both Quest and Labcorp offer HIV testing for $79 via this website:
STD Testing | Pricing & STD Test Packages - STDcheck.com and there is even a $15 off coupon so the lab is accepting $64 as payment in full for the test.
Perhaps a call to the lab to ask for billing at their advertised price might work even though the test was not ordered via the specific program.